{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T23:59:44Z","timestamp":1771027184086,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2015,10,22]],"date-time":"2015-10-22T00:00:00Z","timestamp":1445472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Approach\u2010specific economic data of acoustic neuroma (AN) resection is lacking. The purpose of this study was to analyze and compare adjusted total hospital costs, hospital and intensive care unit (ICU) length of stay (LOS), and associated factors in AN patients undergoing resection by translabyrinthine (TL) approach versus retrosigmoid (RS) approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 113 patients with AN undergoing TL (N = 43) or RS (N = 70) surgical resection between 1999 and 2012 were analyzed. Data including age, health status, preoperative hearing, tumor size, postoperative complications, hospital, ICU LOS, and disposition after discharge were collected from medical records and compared between both groups. Cost data was obtained from the hospital finance department and adjusted based on the Consumer Price Index for 2013.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no significant differences in demographic data, preoperative hearing, preoperative health status, or postoperative complication rate. Total hospital LOS and ICU LOS were significantly longer in the RS compared to the TL group (4.3 \u00b1 3.6 vs. 2.6 \u00b1 1.1 days; P &lt; 0.001, and 1.5 \u00b1 1.1 vs. 1.0 \u00b1 0.5 days; <jats:italic>P<\/jats:italic> = 0.015, respectively). Tumors were larger in RS compared to the TL group (2.1 \u00b1 1.0 cm vs. 1.5 \u00b1 0.7 cm, respectively; <jats:italic>P<\/jats:italic> = 0.002). When patients were stratified by tumor size &lt; or \u2265 2 cm, the total hospital LOS remained greater in the RS group in both subgroups (&lt; and \u2265 2 cm, <jats:italic>P<\/jats:italic> &lt; 0.001, and <jats:italic>P<\/jats:italic> = 0.031, respectively). However, there was no difference in the total ICU LOS between both subgroups. The adjusted mean total hospital cost was higher in the RS compared to the TL group ($25,069 \u00b1 14,968 vs. $16,799 \u00b1 5,724; <jats:italic>P<\/jats:italic> &lt; 0.001). The adjusted mean total hospital cost was greater in the RS group with tumor &lt; 2 cm (<jats:italic>P<\/jats:italic> &lt; 0.001) but not significantly different in patients with tumors \u2265 2 cm. Univariate analysis showed that greater tumor size, poorer preoperative health status, the presence of major postoperative complications, and the RS approach were independently significantly associated with higher total hospital LOS (<jats:italic>P<\/jats:italic> = 0.001, <jats:italic>P<\/jats:italic> = 0.009, <jats:italic>P<\/jats:italic> = 0.001, and <jats:italic>P<\/jats:italic> &lt; 0.001, respectively) and a higher adjusted total hospital cost (<jats:italic>P<\/jats:italic> &lt; 0.001, <jats:italic>P<\/jats:italic> = 0.002, <jats:italic>P<\/jats:italic> = 0.014, and <jats:italic>P<\/jats:italic> &lt; 0.001, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Hospital LOS and total adjusted costs are significantly less for patients undergoing translabyrinthine acoustic neuroma resection compared to the retrosigmoid approach. Many factors appear to influence these differences. Economic considerations in addition to tumor characteristics and surgeon preference should be considered in future acoustic neuroma resections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2c. <jats:italic>Laryngoscope<\/jats:italic>, 126:S5\u2013S12, 2016<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.25729","type":"journal-article","created":{"date-parts":[[2015,10,22]],"date-time":"2015-10-22T10:01:33Z","timestamp":1445508093000},"source":"Crossref","is-referenced-by-count":9,"title":["Retrosigmoid versus translabyrinthine approach to acoustic neuroma resection: A comparative cost\u2010effectiveness analysis"],"prefix":"10.1002","volume":"126","author":[{"given":"Maroun T.","family":"Semaan","sequence":"first","affiliation":[{"name":"University Hospitals Ear Nose and Throat Institute Department of Otolaryngology\u2013Head and Neck Surgery University Hospitals Case Medical Center Cleveland Ohio U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cameron C.","family":"Wick","sequence":"additional","affiliation":[{"name":"University Hospitals Ear Nose and Throat Institute Department of Otolaryngology\u2013Head and Neck Surgery University Hospitals Case Medical Center Cleveland Ohio U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly J.","family":"Kinder","sequence":"additional","affiliation":[{"name":"University Hospitals Ear Nose and Throat Institute Department of Otolaryngology\u2013Head and Neck Surgery University Hospitals Case Medical Center Cleveland Ohio U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John G.","family":"Stuyt","sequence":"additional","affiliation":[{"name":"University Hospitals Ear Nose and Throat Institute Department of Otolaryngology\u2013Head and Neck Surgery University Hospitals Case Medical Center Cleveland Ohio U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca L.","family":"Chota","sequence":"additional","affiliation":[{"name":"Case Western University School of Medicine Cleveland Ohio U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cliff A.","family":"Megerian","sequence":"additional","affiliation":[{"name":"University Hospitals Ear Nose and Throat Institute Department of Otolaryngology\u2013Head and Neck Surgery University Hospitals Case Medical Center Cleveland Ohio U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,10,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.130.2.216"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2011.12.008"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1054\/jocn.2000.0728"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000157170"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21799"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e31820777b1"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200405000-00029"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2005.01.006"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200308000-00013"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813507234"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.3171\/2012.7.FOCUS12193"},{"key":"e_1_2_7_13_1","first-page":"47129","article-title":"Medicare program; changes to the hospital inpatient prospective payment systems and fiscal year 2008 rates","volume":"72","author":"Centers for Medicare and Medicaid Services","year":"2007","journal-title":"Fed Regist"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/1062860609332511"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2010.01.037"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2013.09.023"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2004.02.008"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.3171\/2013.1.JNS121370"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.3109\/02688697.2013.815323"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.3171\/JNS\/2008\/108\/6\/1220"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsb1205901"},{"key":"e_1_2_7_22_1","first-page":"26787","article-title":"Medicare program; prospective payment system for long\u2010term care hospitals RY 2009: annual payment rate updates, policy changes, and clarifications; and electronic submission of cost reports: revision to effective date of cost reporting period. 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